Intraoperative C-arm radiation affecting factors and reduction by an intervention program.

Area of Science:

• Medical Physics
• Surgical Technology
• Radiation Safety

Background:

• Increased use of fluoroscopy in surgery leads to higher ionizing radiation exposure for patients and staff.
• Need for effective strategies to mitigate radiation risks in surgical settings.
• Focus on behavioral changes in fluoroscopy utilization to reduce doses.

Purpose of the Study:

• To evaluate the effectiveness of an intervention program in reducing radiation doses during surgical fluoroscopy.
• To assess the impact of staff awareness and behavioral modification on fluoroscopy utilization and radiation exposure.
• To compare radiation doses and procedure outcomes before and after the intervention.

Main Methods:

• Optimized fluoroscopy techniques through simulations.
• Conducted lectures for surgical staff (surgeons, X-ray technicians) on radiation reduction.
• Implemented pre-operative directives, signage, and post-operative data discussions.
• Compared fluoroscopy time and radiation dose in 43 cases (Group A) vs. 40 cases (Group B) for closed reduction and percutaneous fixation of Gartland III supracondylar humerus fractures.

Main Results:

• Mean fluoroscopy time decreased from 122s (Group A) to 54s (Group B) (P=0.001).
• Mean radiation emission reduced from 202 mrem (Group A) to 90 mrem (Group B) (P=0.005).
• Presence of a senior surgeon further reduced fluoroscopy time and radiation dose.
• Reduction accuracy and complication rates remained comparable between groups.

Conclusions:

• Surgical and fluoroscopic techniques, along with surgeon training level, significantly impact radiation exposure.
• Awareness and behavioral modification are key to significantly decreasing radiation exposure.
• The intervention program effectively reduced radiation doses without compromising procedural accuracy.